More strides against childhood cancer

The treatment of childhood cancer is one of the great success stories of modern medicine. A few decades ago, only 20 percent of children survived the disease. Today, overall survival rates approach 80 percent. Yet cancer remains the leading cause of death from disease in U.S. children older than 1 year of age, and some types of pediatric cancer continue to have poor survival rates.

For researchers, the aim now is to close the survival gap while creating safer, more effective therapies to treat the disease. A further increase in survival rates will require combining the latest technologies with new approaches to drug discovery and innovative clinical trials.

September is Childhood Cancer Awareness Month, a time dedicated to highlighting efforts to reduce cancer's toll on children. At St. Jude Children's Research Hospital, the fight against the disease occurs year round.

"Our goal is to cure more children, and in the process, find new treatments that have less side effects and a greater effectiveness for all children fighting cancer," said Dr. William E. Evans, St. Jude director and CEO.

St. Jude scientists are making progress. In a recent study, St. Jude investigators employed improved risk-adjusted chemotherapy and sophisticated patient monitoring to dramatically boost survival of older teenage patients with acute lymphoblastic leukemia (ALL), a type of blood cancer. Historically, older adolescents with ALL fared far worse than younger children with the disease. The same protocol also showed that cranial irradiation, once regarded a standard treatment for childhood ALL, can be omitted, thus sparing patients from devastating side effects and enhancing their quality of life. The treatment regimen resulted in a 90 percent cure rate, the highest rate ever reported for the disease.

Innovations in bone marrow transplantation are helping close the survival gap by offering new hope to children with high-risk forms of ALL and acute myeloid leukemia, a cancer of certain white blood cells. Using bone marrow transplantation, St. Jude doctors more than doubled survival of such patients, who were not cured using intensive chemotherapy. Patients benefited from improved infection control, more sophisticated transplant donor selection and other treatment advances.

Other St. Jude researchers are leading international efforts to advance understanding of the biology driving several common childhood brain tumors. The work includes clinical trials to translate that understanding into pioneering therapies.

To speed progress against a wide range of pediatric cancers, St. Jude researchers are collaborating with Washington University School of Medicine in St. Louis to decode the genomes of more than 600 childhood cancer patients. The Pediatric Cancer Genome Project is an unprecedented effort to identify the genetic changes that give rise to some of the world's deadliest childhood cancers. The project has already produced a novel computer tool for finding the genetic missteps that fuel cancer.

"Our goals are ambitious, but we are hopeful that by employing science, technology, new computational approaches and scientist-doctor collaborations, we can make more strides against childhood cancer," Evans said.